Clinical and epidemiological profile of leprosy patients attended at Ceará, 2007-2011

Abstract: Background: Leprosy is an infectious chronic condition associated with potentially serious physical, social and psychological impacts. Objectives: To characterize the clinical and epidemiological profile of leprosy patients treated from 2007 to 2011 in the University Hospital of Ceará, Northeastern Brazil. Methods: This is a retrospective and descriptive study. The study population consisted of residents in the state of Ceará treated in a dermatology clinic between 2007-2011. Clinical and epidemiological data analyzed were obtained from medical records and from the database of national Information System for Notifiable Diseases. Results: 475 cases were analyzed, mostly women (51.8%), aged 45-59 years (35.0%) - mean of 45.2 years at diagnosis - with 6.3% of children under 15 , with low education (73.7%), white color (68.8%), residency in the city of Fortaleza (82.3%), and no defined work occupation (59.6%). At diagnosis, most patients were multibacillary (MB) (65.5%), had borderline clinical form (48.0%), and 22.7% had physical disability (8.0% with grade 2), predominantly in MB cases (p <0.001). We observe worsening of disability in 5.1% of cases post-MDT. The proportion of cases with reactional episodes was 42.7%, mainly during MDT (51.2%). Conclusion: This is the first study conducted in this hospital context, revealing late diagnosis, high burden of disease, hidden endemicity, and high social vulnerability in the state of Ceará. This study reinforces the need to strengthen health care network for timely diagnosis and treatment, aiming at longitudinality of assistance.

Infecções urinárias e uso de cateter vesical de demora em unidade pediátrica / Urinary infectionsand use of indwelling bladder catheter in pediatricunit

Objetivou-se identificar os agentes etiológicos de infecção urinária em crianças submetidas ao cateterismo vesical de demora, internadas em uma Unidade de Terapia Intensiva, o tempo de uso e a indicação desse cateter. A população estudada foi composta de crianças atendidas na Unidade Pediátrica de um hospital escola, de julho a dezembro/2006. Os dados foram coletados dos prontuários. A amostra foi de 38 crianças que utilizavam sonda vesical de demora. A principal indicação do cateterismo foi a monitorização do débito urinário. O tempo de uso do cateter vesical 21 (55,3%) foi de 7 a 30 dias, 14 (36,8%) < 7 dias e 3 (7,9%) > 30 dias. O principal agente etiológico evidenciado foi a Escherichia coli (2,6%). Constatou-se que crianças que utilizaram cateter vesical de demora apresentaram considerável taxa de infecção urinária de acordo com os dados da literatura.